Jugular Versus Femoral Venous Access for Leadless Pacemaker Implantation: A Systematic Review and Meta-Analysis

Area of Science:

• Cardiology
• Medical Devices
• Interventional Procedures

Background:

• Leadless pacemakers (LPMs) offer reduced complications compared to conventional pacing.
• Transfemoral access (FA) is the standard implantation route for LPMs.
• Transjugular access (JA) is an emerging alternative with limited comparative data.

Purpose of the Study:

• To systematically review and meta-analyze comparative evidence between JA and FA for LPM implantation.
• To evaluate electrical performance, procedural efficiency, and complication rates.
• To determine the safety and efficacy of JA as an alternative to FA.

Main Methods:

• Systematic identification of studies comparing JA and FA for LPM implantation.
• Pooled analysis of electrical parameters (pacing threshold, R-wave amplitude, impedance).
• Comparison of procedural efficiency (total time, fluoroscopy duration) and complications.

Main Results:

• No significant differences in pacing threshold, R-wave amplitude, or impedance between JA and FA.
• Comparable total procedural times between the two approaches.
• JA demonstrated significantly reduced fluoroscopy time, overall procedural complications, and wound-related adverse events compared to FA.

Conclusions:

• Transjugular access (JA) provides equivalent electrical performance to transfemoral access (FA) for leadless pacemaker implantation.
• JA significantly reduces fluoroscopy exposure and access-related complications.
• JA is a safe and effective alternative for leadless pacemaker implantation.